scholarly journals MUCOSAL ABNORMALITIES AS AN ETIOPATHOGENETIC FACTOR IN THE DEVELOPMENT OF GINGIVAL RECESSION

2021 ◽  
Vol 17 (2) ◽  
pp. 14-18
Author(s):  
Said Ksembaev ◽  
Dinar Busheev ◽  
Ilsiyar Valieva ◽  
Aiygul Khaliullina ◽  
Lilia Khafizova

Subject. A review of the literature devoted to the current problem of dentistry - mucogingival anomalies (small vestibule of the mouth, short frenulum of the lips, tongue, muco-alveolar cords) is presented. Purpose of the study — study the materials of publications devoted to mucogingival anomalies as etiopathogenetic factors in the development of gingival recession. Methodology. In detail, in the light of modern ideas described mucogingival anomalies (shallow vestibule of the mouth, short frenulum of the lips, tongue, mucous-alveolar cords) and their effect on the development of gum recession. Results. It has been established that a large role in the occurrence and development of gingival recession is played by the ratio of the size of the attached and free gums, which is normally equal to 5: 1, and in pathology — 1: 1. The pathogenetic mechanism of the negative impact of mucogingival abnormalities is associated with the absence, first of all, of a sufficient width of the attached gums with a shallow vestibule of the mouth, which is a factor of constant chronic trauma to the gums with, leading to disturbances in microcirculation and tissue metabolism, resulting in resorption of bone structures, etermined radiographically. In the mechanism of gum recession, a significant role is also played by the pulling mucous-alveolar cords, shortened and massive frenum of the lips and tongue. The main signs of arising ischemic disorders are anemization and mobility of the marginal gums when the lower or upper lip, cheeks, and tongue are abducted. To prevent severe destructive lesions, it is necessary to timely identify and eliminate, with the help of vestibulo- or frenuloplasty operations, conditions conducive to functional chronic traumatization of the periodontal tissues. Conclusions. The results of the review indicate that knowledge of the anatomical and topographic parameters of the vestibule and oral mucosa is necessary to prevent the development of gingival recession, prescribe timely and adequate treatment, predict and prevent complications. However, it should be recognized that this problem, in our opinion, continues to remain relevant to this day due to the lack of an integrated approach to the prevention, diagnosis and treatment of gum recession.

Author(s):  
Elena F. KIREEVA

The article considers the problem of reforming national finances at the present stage of economic development, taking into account the features of the functioning of the national economy and fiscal threats. The purpose of this work is to determine the strategy for reforming the fiscal system and substantiate the main directions of its development. The relevance of the study is due to an integrated approach to the formation of fiscal policy, including both its main components: tax, budget, debt policies, and the need to improve the mechanism to ensure their effectiveness. To implement this mechanism, it is necessary to use both innovative methods of planning and forecasting fiscal flows, and to modernize the legal framework that strengthens the foundations of managerial decisions in the field of finance. Based on the goal, a comparative assessment of the forecast and actual scenarios of the development of fiscal relations in the republic was carried out, the most acute points of fiscal policy formation were analyzed: social payments, tax administration, budget financing, debt obligations, information support for the movement of financial flows. Based on the results of the research conducted in the article, conclusions and suggestions are made regarding all areas of improving fiscal policy as the basis for ensuring an effective national financial management strategy. Priority measures have been identified to reduce the negative impact of risks on the stability of the fiscal system. Instruments of regulatory impacts on negative economic and social trends are determined by the choice of areas of strategic management and the mechanism of their organizational support. Scientific novelty lies in the substantiation of a set of elements of fiscal policy as the basis for developing a strategy for managing national finances that takes into account the increase in the social and economic efficiency of using the financial resources of the state.


2021 ◽  
pp. 232020682110034
Author(s):  
Hamad Alzoman ◽  
Khalid Alamoud ◽  
Waad K. Alomran ◽  
Abdullazez Almudhi ◽  
Naif A. Bindayel

Aim: To evaluate the periodontal status before and after orthodontic treatment and to analyze the confounding factors associated with it. Materials and Methods: The present retrospective study analyzed pre- and posttreatment records of a total of 60 patients. Intraoral digital photographs before and after the orthodontic treatment were used to measure the following three periodontal variables: (a) width of the keratinized gingiva, (b) gingival recession, and (c) the status of interdental papilla. The ImageJ 46 software imaging program was used to perform the required measurements. The clinical data were then analyzed in an association with the participants’ demographic data, the type of orthodontic tooth movement, and other confounding factors. The data obtained were manually entered into the statistical package and analyzed using a significance level set at P < .05. Descriptive statistics, paired t-tests, and Pearson’s correlation analysis were used to identify differences among the studied variables. Results: Among the 60 patients, the majority (66.7%) were females. Most cases of the treated malocclusion were Class II, and most patients underwent intrusion and retrusion movements. The width of keratinized gingiva increased for most sites of upper teeth. In contrast, the lower teeth showed a mix of improvement and compromised width of keratinized gingiva. As a measure of gingival recession, the difference of clinical crown height revealed the tendency toward a reduced clinical crown height for most sites. Upper left lateral incisors and canines showed significant values with regard to keratinized gingival width measurements and tooth movements such as extrusion and intrusion movements. Likewise, with regard to the clinical crown height, upper right central incisors showed significant differences when correlated with the interincisal angle, lower incisors to the mandibular plane, and upper incisors to the NA line. The upper lateral incisors also showed significant correlations to certain cephalometric measurements. Conclusions: The orthodontic treatment was found to exert a significantly positive impact on the surrounding periodontium, particularly in the upper canine areas. Likewise, various types of tooth movement were found to positively affect the periodontium.


Author(s):  
Roberta Patalano ◽  
Vincenzo De Luca ◽  
Jess Vogt ◽  
Strahil Birov ◽  
Lucia Giovannelli ◽  
...  

According to the World Health Organization (WHO), the worldwide obesity rate has tripled since 1975. In Europe, more than half of the population is overweight and obese. Around 2.8 million people die each year worldwide as a result of conditions linked to being overweight or obese. This study aimed to analyze the policies, approaches, and solutions that address the social and health unmet needs of obese patients, at different levels, in order to simulate the definition of an integrated approach, and to provide and share examples of innovative solutions supporting health promotion, disease prevention, and integration of services to improve the collaboration between the different health and care stakeholders involved across the country and in the lives of obese patients. A collaborative approach involving various levels of government and regional experts from different European countries was applied to identify, explore, and evaluate different aspects of the topic, from the innovation perspective and focusing on a European and a regional vision. Currently, people prefer more foods rich in fats, sugars, and salt/sodium than fruits, vegetables, and fiber. This behavior leads to a significant negative impact on their health-related quality of life. Changes in healthcare systems, healthy policy, and approaches to patient care and better implementation of the different prevention strategies between all the stakeholders are needed, taking advantage of the digital transformation of health and care. Such changes can support obese patients in their fight against an unhealthy lifestyle and at the same time reduce healthcare costs.


2002 ◽  
Vol 55 (5-6) ◽  
pp. 229-232 ◽  
Author(s):  
Marija Bokor-Bratic

Introduction The exact mechanisms by which smoking effects the periodontal tissues are not known. Studies in which plaque or calculus are taken into consideration come to conflicting conclusions regarding effects of smoking. Aim The aim of this study was to examine the oral hygiene and periodontal status in smokers and compare them with nonsmokers. Material and methods The study group comprised 83 smokers and 83 nonsmokers. The mean age (SD) of smokers and nonsmokers was 42,4?7,0 years and 43,7?6,4 years, respectively. The age difference was not statistically significant. The average tobacco consumption of the smokers at the time of investigation was 14 cigarettes a day and they had been regular smokers for 21 years on average. Results The amount of dental plaque was evaluated in accordance with the criteria of Green-Vermillion by using disclosing solution. The periodontal condition was evaluated by Ramfjord Periodontal Disease Index. For gingival recession the distance from the cemento-enamel junction to the gingival margin was determined on mid-buccal and mid-lingual surfaces of all teeth. Each subject was radiographically examined with a full mouth intraoral survey. Alveolar bone loss was determined as the distance from the cemento-enamel junction to the point where lamina dura became continuous with the compact bone of the interdental septum. Mean alveolar bone loss based on all mesial and distal measurements was calculated for each subject. The amount of dental plaque was high in both smokers (2,60,60) and nonsmokers (1,50,70), whereas the differences were statistically significant (p<0.001). Conclusion Periodontal destruction, alveolar bone loss and gingival recession were significantly increased in smokers compared to nonsmokers (p<0.001). It is concluded that differences observed between smokers and nonsmokers with regard to periodontal condition are attributable to differences in oral hygiene. Smoking is a risk factor for periodontal health.


2020 ◽  
Vol 22 ◽  
pp. 01010
Author(s):  
Natalya Krivenko ◽  
Daria Epaneshnikova

The article considers modern demographic trends, in the conditions of medical care cost increasing and aging of the population. The expediency of studying aspects of health care efficiency is justified. The relationship and mutual influence of changes in the country’s economy and changes in the health care system are revealed. The problems of preserving the health of the population are considered comprehensively, taking into account the influence of environmental factors, behavioral factors and attitudes to human health, the effectiveness of public policy implementation and the effectiveness of the health system. An integrative model for evaluating the effectiveness of regional health care is proposed based on an integrated approach aimed at improving the population health and ensuring social and demographic security of the region. The integrative model is adapted on the example of the Sverdlovsk region. In dynamics for 2008-2018, improved medical and demographic indicators and high effects were achieved as a result of comprehensive measures to neutralize factors that have a negative impact on the health of the population, promotion and implementation of healthy lifestyle, strengthening state support for the industry, and the successful functioning of regional health care.


2010 ◽  
Vol 4 (2) ◽  
pp. 75
Author(s):  
Lúcia Grando Bulcão ◽  
Helton de Assis Albano

A disposição inadequada dos resíduos sólidos, atualmente, constitui um problema para a sociedade, tendo em vista os impactos ambientais que provoca, alterando a qualidade do solo, do ar e dos corpos aquáticos, e representando um risco para a saúde pública. Este artigo aborda aspectos do gerenciamento de resíduos sólidos na região Metropolitana II do Estado do Rio de Janeiro, discutindo ações desenvolvidas nesta área, da coleta à destinação final. Mais especificamente, analisa aspectos relacionados às classes de resíduos, resíduos sólidos gerados e triados, à situação atual da destinação final e ao gerenciamento de resíduos hospitalares, traçando-se, ao final, um panorama da situação do gerenciamento dos resíduos sólidos local. Durante os meses de janeiro a junho de 2008, foram realizadas visitas aos locais de destinação final dos resíduos sólidos - os aterros controlados e lixão, bem como entrevistas com técnicos responsáveis pelas ações de gerenciamento dos resíduos sólidos das Secretarias Municipais do Meio Ambiente, de Obras e de vigilância ambiental em saúde das Secretarias de Saúde, dos municípios da Região Metropolitana II, a saber: Niterói, São Gonçalo, Itaboraí, Maricá, Tanguá, Rio Bonito e Silva Jardim. A região Metropolitana II do Estado do Rio de Janeiro, embora composta por municípios com realidades bastante diferenciadas em termos de desenvolvimento social e econômico, possui grande parcela da população vivendo em condições precárias e sem acesso aos serviços públicos de saneamento, saúde e educação, vulnerável aos impactos ambientais. Verifica-se que a disposição final com o tratamento adequado dos resíduos sólidos constitui importante problema, não só para os governos e políticas públicas locais, mas também para as populações que convivem com os lixões. Destaca-se o importante papel dos catadores informais pelas cidades, muitos se organizando em pequenas cooperativas e grande parte operando em áreas urbanas onde o lixo é armazenado, aguardando coleta pública, ou, ainda, em alguns dos aterros controlados e no lixão da região. Há urgência de implantação de aterros sanitários ou aterro consorciado, desativando-se as áreas atuais de lixões e/ou aterros controlados, com ações de remediação de áreas degradadas, e, enfim, que se adotem soluções que dêem conta dessa importante parcela do saneamento básico, minimizando o impacto negativo dos solos e águas subterrâneas contaminados, visando-se a sustentabilidade da saúde e do ambiente, e o bem-estar das pessoas. Palavras-chave: Resíduos sólidos, Gerenciamento de resíduos sólidos Abstract The inadequate disposal of the solid residues, nowadays, is a social problem, concerning to suffered environmental impact, changing the quality of the soil, the air and of the water, being a risk to the public health. This article is about aspects of solid residues management at Metropolitana II region of the Rio de Janeiro state, discussing the development of actions on this area, from the collect to the final destination. More specifically, we analyze aspects related to the classes of residues, solid residues that were generated and discriminated, the actual situation of the final destination and to the management of the hospitals residues, constructing, at the end, a view of the local management of the solid residues. From January to June of 2008, visits were made at the locals of the final destination of the solid residues – the controlled landfills and the disposal waste areas, as well interviews with responsible technicians about actions of solid residues management of the environmental municipal secretaries, of Metropolitana II region: Niterói, São Gonçalo, Itaboraí, Maricá, Tanguá, Rio Bonito e Silva Jardim. The Metropolitana II region of the Rio de Janeiro state, although composed of very different realities between the municipals, concerning to economic and social development, has great portion of the population living in precarious conditions and without access to sanitary public services, health and education, vulnerable to the environmental impacts. We verify that the final disposal with adequate treatment of the solid residues constitute import problem, not only to the government and local public policies, but also to the population that live within waste. We mark the important function of the informal garbage pickers in the cities, many of them organized in small co-operative societies and a great part acting in urban areas where the trash is stored, waiting public collecting, or at some controlled landfill and disposal waste area. It's urgent the implementation of the sanitary landfills or partnership landfills, discarding the actual areas of waste disposal and/or controlled landfill, with remediation actions on the deteriorate areas, and, finally, solutions must be adopted to solve this important portion of the basic sanitation, minimizing the negative impact of the soil and contaminated subterranean water, aiming the health and the environmental support, and the well being of people. Keywords: Solid waste, Solid waste management


2009 ◽  
Vol 24 (2) ◽  
pp. 333-341
Author(s):  
Serge Beslier

AbstractThis paper examines how marine biodiversity and genetic resources in the high seas can be protected and whether their exploitation should be regulated. As to their protection, it raises the question whether existing sectoral approaches should continue or to create a new mechanism based on an integrated approach. In accordance with the European Union's position, the latter is favoured, while acknowledging that several States still have reservations and question the need for new legal instruments. Concerning the necessity of a regulatory scheme governing their exploitation, existing mechanisms under the Law of the Sea Convention and the Convention on Biological Diversity are examined and it is concluded that they are not applicable or do not provide for specific rules on this issue. It is further presumed that the resulting absence of a clear framework is acceptable because the potential of commercial exploitation is still uncertain, so that there will only be scientific research without vital negative impact on the marine environment in the near future. It is suggested that the international community should rather focus on defining the legal status of genetic resources and clarifying whether they belong to the common heritage of mankind and require a benefit-sharing system, as proposed by developing countries.


2020 ◽  
pp. 25-31
Author(s):  
P. Mazur ◽  
I. M. Suprunovych

Gingival recession is a common clinical condition in the dental practice, which is characterized by the root surface exposure due to the apical displacement of the marginal gingival tissues. Since the teeth' root surfaces become open to the environment of the oral cavity, the consequences of gingival recession are a disturbance of aesthetics (mainly when they occur in the frontal area), the development of hypersensitivity root caries, and non-carious cervical lesions. Despite the numerous studies carried out, the exact mechanism of the development of gingival recession is not fully understood, and it is generally accepted that it has a multifactorial etiology. Gingival recession can occur directly due to an infectious and inflammatory process in the periodontal tissues, anatomical features, as a result of the effect of mechanical or iatrogenic factors on soft tissues, or their action in combination with each other. The prevalence of gingival recessions worldwide varies from 22 to 100% and mainly depends on age, the size of the studied population, diagnostic criteria, and statistical data processing methods.  The aim was to determine the influence of age on the prevalence of gingival recession in patients with periodontitis.  Materials and methods. One hundred thirty-three patients with periodontitis aged 29 to 59 years were included in the study and divided into four groups according to their age: 20–29 years, 30–39 years, 40–49 years, 50–59 years. Inclusion criteria were the presence of periodontitis, age over 20 years, and the presence of more than 20 teeth in the oral cavity.  Participants were interviewed about demographic data, smoking status, and oral hygiene skills. All patients underwent a clinical examination using the clinical and instrumental program Florida Probe system. Gingival recession was recorded in the presence of root surface exposure of 1 mm or more. According to the size of the exposed surfaces of the tooth roots, three degrees of severity of gingival recession were assessed: mild gingival recession (less than 3 mm), moderate gingival recession (3 to 4 mm), severe gingival recession (5 mm or more). The severity of gingival recession was estimated in mm as the distance between the cemento-enamel junction and the gingival margin. Subsequently, the gingival recession was classified using the Miller recession classification [7]. Results of the studies and their discussion. The study results showed that a high prevalence of gingival recession was found in patients with periodontitis in the Ukrainian population. Exposure of the surface of the teeth' roots by 1 mm or more was present in around 2233 teeth, which corresponds to 65.86 (61.4-70.3)% of all examined teeth. The average number of teeth with the gingival recession increases with age: in those aged 20-29, the gingival recession was present in 42,86% of the teeth, in patients 30-39 years of age, the gingival recession was present in around 59,59% of the teeth, in patients 40-49 years of age the gingival recession was present in around 70,49% of the teeth, in those, older than 50 years, the gingival recession was present in around 82.72% of the teeth. Incisors and first molars were the most affected teeth by the gingival recession. In patients with periodontitis, the gingival recession of mild degree (up to 3 mm) was determined around 44.01 (40.8-47.2) % of teeth, the gingival recession of moderate degree (from 3 to 4 mm) – around 17.41 (14.3-20.5) % of teeth, the gingival recession of severe degree (5 mm or more) – around 4.42 (2.7-6.2)% of teeth. The severity of recession in patients of different age groups was determined: the gingival recession's severity increases with age. The average severity of gingival recession (the length from the cemento-enamel junction to the gingival margin) was determined in patients of different age groups: in the group of 20 years old, it was 0.28 ± 0.28 (M ± SD) mm, in the group of 30 years old – 0.43 ± 0.37 (M±SD) mm, in the group of 40 years old – 0.78 ± 0.70 (M ± SD) mm, in the group of 50 years old – 1.20 ± 0.70 (M±SD) mm. According to the Millers classification, Class III of the gingival recession was more common in age groups I and II, Class IV of gingival recession, which have an unfavourable prognosis of treatment, were more often manifested in older patients age groups.


2020 ◽  
Vol 16 (1) ◽  
pp. 81-86
Author(s):  
Rushana Farkhshatova ◽  
Larisa Gerasimova ◽  
Irina Usmanova

Subject. Gingival recession refers to a form of periodontal disease, which is characterized by a decrease in the free gum without signs of chronic inflammation in the apical direction of the gum and periodontal tissues. The goal is to determine the clinical and radiological features of periodontal tissues in patients with gum recession. Methodology. A comprehensive diagnostic examination was conducted according to a specially developed algorithm of 47 patients aged 20 to 45 years old with a diagnosis of gum recession, which included the collection of anamnestic data, special questionnaires, clinical, radiological and ultrasound examinations of periodontal tissues. Results. According to clinical and radiological data, the diagnosis of gum recession was confirmed in all patients: in 31 (62 %) ― Miller's class I gum recession, in 11 (25 %) ― II, in 5 (11 %) ― III and in 1 (2 %) ― IV. The dependence of the gum recession on the quality of oral hygiene was determined: with satisfactory oral hygiene (OHI-S <2.6), the depth of the gum recession was 1-1.5 mm, with poor (OHI-S> 2.6) ― more than 1,5 mm. In 14 (42.8 %) patients, a concomitant diagnosis of chronic generalized catarrhal gingivitis was established, in 57.2 % of patients with chronic generalized periodontitis. Of the total number of patients, a thin biotype was determined in 30 (63.8 %) patients, and a thick biotype was identified in 17 (36.2 %). A combination of a thin biotype with a small vestibule of the oral cavity, the presence of anomalies of the frenum and strands of the mucous membrane in 23.4 % was revealed. Conclusions. Miller class I gingival recessions have the highest frequency of occurrence (62 %). The ultrasonic research method allowed non-invasive determination of the gingival biotype and gum thickness. A thin biotype of the gum was diagnosed in 63.8 % of patients, which must be taken into account when planning surgical treatment.


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